Infusion systems

ABSTRACT

An infusion system comprises an infusion set ( 30 ) with one or more advanced features including tube set strain relief ( 10 ), infusion pumps having heat exchange abilities and two-direction pumping abilities ( 100 ), Piezo pump devices ( 200 ), reservoirs ( 220, 240 ) made from expanded tubing, and oil impregnated pump plungers ( 302 ). An exemplary strain relief ( 10 ) includes an adhesive layer ( 12 ) such as pressure sensitive adhesive (PSA) secured to a base ( 14 ). The base ( 14 ) rotatably receives a pin ( 18 ) of a tube holder ( 16 ). The pin ( 18 ) is captured within an opening ( 22 ) of the base ( 14 ) to allow 360 degree rotation of the tube holder ( 16 ).

CROSS-REFERENCE TO RELATED APPLICATIONS

The application claims the benefit under 35 U.S.C. 119(e) of a U.S.provisional patent application of Gary M. Searle et al. entitled“Concepts for Infusion Set Strain Relief, an Oil Impregnated Plunger, aReservoir Made from Expanded Tubing, and Piezo Pump Devices”, Ser. No.61/441,278, filed Feb. 9, 2011 the entire content of said applicationbeing incorporated herein by reference.

FIELD OF THE INVENTION

The present invention relates generally to components and elements ofinfusion systems, specifically an infusion set with one or more featuresincluding tube set strain relief, infusion pumps having heat exchangeabilities, oil impregnated plungers, two-direction pumping abilities,Piezo pump devices, and reservoirs made from expanded tubing.

BACKGROUND OF THE INVENTION

A large number of people suffering from diabetes use some form of dailyinsulin therapy to maintain close control of their glucose levels.Currently, there are two principal modes of daily insulin therapy. Thefirst mode includes syringes and insulin pens. These devices are simpleto use and are relatively low in cost, but they require a needle stickat each injection, typically three to four times per day. The secondmode includes infusion pump therapy, which entails the purchase of aninsulin pump that lasts for about three years. The initial cost of thepump can be significant, but from a user perspective, the overwhelmingmajority of patients who have used pumps prefer to remain with pumps forthe rest of their lives. This is because infusion pumps, although morecomplex than syringes and pens, offer the advantages of continuousinfusion of insulin, precision dosing and programmable deliveryschedules. This results in closer blood glucose control and an improvedfeeling of wellness.

An infusion pump is but one part of an assembly of infusion elements,which work together to deliver insulin or other medicament to aninfusion site. Some elements are disposable, such as the infusion set orpump set which conveys the insulin from a reservoir within the pump intothe skin of the user. An infusion set typically consists of a pumpconnector, a length of tubing, and a hub or base from which an infusionneedle, flexible cannula or catheter extends. The hub or base has anadhesive which retains the base of the set on the skin surface duringuse, which may be applied to the skin manually or with the aid of amanual or automatic insertion device.

As noted above, infusion sets allow diabetic patients to infuse insulinvia an infusion pump. To do so, infusion sets use one or more of aninfusion needle, flexible cannula or catheter. For example, a steelinfusion needle can be used to infuse insulin under the skin surface,either into the subcutaneous or intradermal skin layers, but mayirritate the insertion site if moved. Alternatively, a soft,Teflon-based catheter can be provided with the infusion set to infuseinsulin under the skin surface, usually into the subcutaneous skinlayer, and is associated with less irritation than a steel cannula.However, soft cannulas or catheters are prone to kink which can delay orinterrupt the insulin delivery and reduce therapy.

Most soft cannula or catheter infusion sets are inserted using anothercommonly associated element of infusion sets, a steel introducer needlethat is positioned inside the catheter lumen and which extends beyondthe catheter to initiate penetration. At insertion and placement, theintroducer needle and catheter are both inserted into the infusion siteeither concurrently with or subsequent to adhesive placement of theinfusion set to the skin surface. The introducer needle is then removedfrom the catheter after penetration, leaving the catheter in place.

Some infusion sets also provide and use a separate spring-loadedinserter that propels the infusion set and/or the introducer needle andcatheter into the tissue at a desired speed and to a desired depth. Manysuch spring-loaded inserters further provide features to automaticallyretract or shield the introducer needle. Once in place, an infusion setis typically attached to a medicament supply using still anotherelement, such as a length of tubing, which can be subject to inferenceand adversely affect the infusion set.

Accordingly, each element of the infusion set needs to operateseparately and in combination, in an optimal manner. Otherwise, theperformance of the infusion set can be adversely affected through thepoor performance of individual elements of the infusion set.

SUMMARY OF THE INVENTION

An object of the present invention is to substantially address the aboveand other concerns, and provide advanced, improved, and novel componentsand elements of infusion systems that further provide simplicity inmanufacture and improvements in use for both insulin and non-insulinapplications.

Another object of the present invention is to provide an infusion systemfor containing and placing an introducer needle, infusion needle,flexible cannula or catheter, an infusion set or other skin contactingelement including strain relief features for tube set connections andwhich avoid the transmission of movement to the introducer needle,infusion needle, flexible cannula or catheter.

Another object of the present invention is to provide an infusion systemfor containing and placing an introducer needle, infusion needle,flexible cannula or catheter, an infusion set or other skin contactingelement including tubing recoiler features for managing the tubing ofthe tube set connection.

Another object of the present invention is to provide an infusion systemfor containing and placing an introducer needle, infusion needle,flexible cannula or catheter, an infusion set or other skin contactingelement including an expandable and collapsible reservoir, andincorporating such expansion and collapse into the operation of theinfusion set.

Another object of the present invention is to provide an infusion pumpfor use with an infusion system, wherein the pump is configured tooperate in both a forward and reverse direction, and incorporating suchforward and reverse direction into the operation of the infusion set.

Another object of the present invention is to provide an infusion pumpfor use with an infusion system, wherein the pump is configured toincorporate a Piezo device, and incorporating such Piezo operation intothe operation of the infusion set.

Another object of the present invention is to provide an infusion pumpfor use with an infusion system, wherein the pump is configured toincorporate a heat exchanger to maintain, cool or heat contents orcomponents of the pump.

Another object of the present invention is to provide an infusion pumpfor use with an infusion system, wherein the pump is configured toincorporate an oil impregnated plunger, and incorporating such an oilimpregnated plunger into the operation of the infusion set.

These and other objects are substantially achieved by providingcomponents and elements of infusion systems, including infusion setswith one or more features including tube set strain relief, infusionpumps having heat exchange abilities, oil impregnated plungers,two-direction pumping abilities, and Piezo devices, and reservoirs madefrom expanded tubing, and incorporating such features into the operationof the infusion set.

BRIEF DESCRIPTION OF THE DRAWINGS

The various objects, advantages and novel features of the exemplaryembodiments of the present invention will be more readily appreciatedfrom the following detailed description when read in conjunction withthe appended drawings, in which:

FIGS. 1A to 1C are perspective views of an exemplary universal strainrelief in accordance with an embodiment of the present invention;

FIGS. 2A and 2B are perspective views of an exemplary integrated spokedesign strain relief in accordance with an embodiment of the presentinvention;

FIGS. 3A to 3C are perspective views of an exemplary universal,inserter-placed strain relief in accordance with an embodiment of thepresent invention;

FIGS. 4A and 4B are perspective views of an exemplary integrated strainrelief in accordance with an embodiment of the present invention;

FIG. 5 is a perspective view of an exemplary concertina-type strainrelief in accordance with an embodiment of the present invention;

FIG. 6 is a perspective view of an exemplary two-part strain relief inaccordance with an embodiment of the present invention;

FIGS. 7A to 7E are block diagrams of an infusion system incorporating alinear peristaltic pump that can be used to deliver insulin or othermedicament to an infusion site in accordance with an embodiment of thepresent invention;

FIGS. 8A to 8D are perspective views of the infusion system of FIGS. 7Ato 7E that can be used to deliver insulin or other medicament to aninfusion site in accordance with an embodiment of the present invention;

FIGS. 9A to 9C are views of an infusion system incorporating a Piezodevice that can be used to deliver insulin or other medicament to aninfusion site in accordance with an embodiment of the present invention;

FIGS. 10A and 10B are views of a tube element that can be used todeliver insulin or other medicament to an infusion site in accordancewith an embodiment of the present invention;

FIGS. 11A and 11B are views of another tube element that can be used todeliver insulin or other medicament to an infusion site in accordancewith an embodiment of the present invention;

FIGS. 12A to 12D are views of another element that can be used todeliver insulin or other medicament to an infusion site in accordancewith an embodiment of the present invention; and

FIG. 13 is a view of a tubing recoiler utilized as part of an infusionpump and infusion set connection in accordance with an embodiment of thepresent invention.

Throughout the drawings, like reference numerals will be understood torefer to like parts, components and structures.

DETAILED DESCRIPTION OF THE EXEMPLARY EMBODIMENTS

The exemplary embodiments of the present invention described belowprovide novel means of delivering insulin via an infusion set with oneor more advanced features including tube set strain relief, infusionpumps having heat exchange abilities, oil impregnated plungers,two-direction pumping abilities, Piezo pump devices, and reservoirs madefrom expanded tubing.

In these and other infusion systems, the use of a strain relief canbenefit a user in a number of ways, including the extension of theuseful life of an infusion set by reducing or eliminating themicro-motion of the catheter caused by movement or tugging of the lineset. Further, by eliminating the influence of line set tugging, suchprovision of a strain relief can ultimately eliminate tunneling orleakage at the infusion site. Accordingly, an exemplary embodiment ofthe present invention incorporates a strain relief device into aninfusion set, and inserter device, or both. FIGS. 1A to 1C areperspective views of an exemplary universal strain relief in accordancewith an embodiment of the present invention.

In FIG. 1A, a universal strain relief 10 is shown, including an enlargedillustration of the assembly with a tube 20 of a set 30. In theexemplary embodiment shown in FIG. 1A, the strain relief 10 comprises anadhesive layer 12 such as pressure sensitive adhesive (PSA) secured to abase 14. The base 14 rotatably receives a pin 18 of a tube holder 16. Asshown in the enlargement of FIG. 1A, the pin 18 is captured within anopening 22 of the base 14 to allow 360 degree rotation of the tubeholder 16. The tube holder 16 can comprise a circular segment offlexible material with an open portion to allow insertion of the tube.The circular segment can be configured to deflect into an open positionupon receiving the tube, and contract to a position to secure the tubeonce the tube is in position. An adhesive liner can also be provided tocover the adhesive layer 12.

In an exemplary use, a user first removes the adhesive liner from thelower surface to expose the adhesive layer of the bottom of the device10. The device 10 is then secured near an infusion site, infusion pump,or therebetween, using the exposed adhesive layer. This ensures that thedevice 10 is fully contacting and adhesively secured to the skinsurface. The user then presses the tube 20 of the tube set into the tubeholder 16 as shown in FIG. 1C.

The tube holder can further comprise an adhesive tab 24 as shown in FIG.1B that can be used to hold the tube to the tube holder. In an exemplaryuse, a user first removes the adhesive liner from the lower surface toexpose the adhesive layer of the bottom of the device 10. The device 10is then secured near an infusion site, infusion pump, or therebetween,using the exposed adhesive layer as discussed above. The user thenpresses the tube 20 of the tube set into the tube holder and removes theadhesive liner from the adhesive tab 24 which is then placed over thetube and the opening of the tube holder.

The strain relief 10 of FIGS. 1A to 1C is universal in that it can beused with any set or infusion pump, any tube configuration, and provide360 degree rotation of the tube. The strain relief 10 can also be usedto hold a strain relief loop in place for any set. In yet otherembodiments of the present invention, the strain relief device 10 can beintegrated into the infusion set. FIGS. 2A and 2B are perspective viewsof another strain relief incorporated with the infusion set inaccordance with an embodiment of the present invention.

In FIGS. 2A and 2B, an exemplary integrated, spoke-design strain relief40 is shown, including an enlarged illustration of the assembly with atube 46 of an infusion set 50. In the exemplary embodiment shown, thestrain relief 40 comprises one or more flexible arms 42 secured to a set50 in a spoke-design pattern. Each arm 42 comprises a slot 44 forsecuring the tubing 46. Specifically, the slot 44 can comprise acircular segment of flexible material with an open portion to allowinsertion of the tube. The circular segment can be configured to deflectinto an open position upon receiving the tube, and contract to aposition to secure the tube once the tube is in position. The slot canfurther comprise an adhesive tab (not shown) that can be used to holdthe tube to the slot substantially as described it the embodiment above.

In an exemplary use, a user first places the infusion set 50 at aninfusion site. The user then forms a loop of tubing and presses portionsof the tubing loop into each slot 44 of each arm 42. As shown in theenlargement of FIG. 2B, the tubing 46 is snapped into the slots 44 ofthe arms 42 which then hold the tube 46 while providing strain relief.In this embodiment, no additional elements are required as the strainrelief element is incorporated with the infusion set. The ability tocombine such elements, either integrated with one another, stored withone another, or installed with one another, can simplify use. Forexample, an inserter can be configured to place both the infusion setand the strain relief, in a single motion. FIGS. 3A to 3C areperspective views of an exemplary universal, inserter-placed strainrelief in accordance with an embodiment of the present invention.

In FIGS. 3A to 3C, an exemplary inserter 60 is shown having an infusionset placement opening 62 and a strain relief placement opening 64 withina single housing. The housing of the inserter 60 contains therein theinfusion set and strain relief elements at a distal end, and a singleuser push button 66 at a proximal end. Both elements can be containedtherein and covered with an adhesive layer and layer cover (not shown).One or more push buttons 66 can be provided to activate the inserter andsimultaneously place the set 68 and the strain relief 70, which can beseparate elements as shown in FIG. 3A, or integrally formed in yet otherembodiments of the present invention as shown in FIG. 4B describedbelow. In doing so, a single user action can be used to place both theset 68 and the strain relief 70 at an insertion site, without requiringseparate user actions. The infusion set and strain relief can share acommon adhesive base (not shown) for installation, or can be providedwith separate adhesive bases.

An exemplary strain relief 70 is shown in FIG. 3C including anillustration of the assembly with a tube 74 of a set 68 in FIG. 3B. Inthe exemplary embodiment shown in FIG. 3C, the strain relief 70comprises a patch having a raised feature and one or more flexibleopenings or detents 72 for the tubing 74 to snap into. Specifically, theflexible openings or detents 72 can comprise a circular opening offlexible material with an open portion to allow insertion of the tube.The circular opening can be configured to deflect into an open positionupon receiving the tube, and contract to a position to secure the tubeonce the tube is in position. The opening can further comprise anadhesive tab (not shown) that can be used to hold the tube to theopening substantially as described it the embodiments above. As shown inFIG. 3B the tubing 74 is snapped into the opening 72 to hold the tubewhile providing strain relief.

In an exemplary use, a user first grips the inserter 60 and places thedistal end of the inserter against a skin surface. The user can thenpress the single button 66 to automatically place both the infusion set68 at an infusion site, and place the strain relief 70 at a positionnear the infusion set 68. The user then forms a loop of tubing andpresses a portion of the tubing loop into the flexible openings ordetents 72 of the strain relief 70. In this embodiment, no additionalelements are required as the strain relief element is packaged with theinfusion set within the inserter 60. In other exemplary embodiments, thestrain relief element can be incorporated with the infusion set. Such anexemplary strain relief element incorporated with an infusion set isshown in FIGS. 4A and 4B, which are perspective views of anotherintegrated strain relief in accordance with an embodiment of the presentinvention.

In FIG. 4A, a low-profile infusion set 80 is shown as placed with a tubeset connection element 82 integrated with, but isolated from, theinfusion set 80. Specifically, as shown in FIG. 4B, the infusion set 80and the tube set connection element 82 are coupled via a tortuous pathedor zigzag patterned portion of a base 88 (with or without adhesive), anda similarly patterned portion of tubing 86 between the low-profileinfusion set 80 and tube set connection element 82. In doing so, a tubeset 84 can be attached to the tube set connection element 82 and placedin fluid communication with the infusion set 80, but wherein theinfusion set 80 is isolated from movement of the tube set 84 by thetortuous pathed or zigzag patterned portion of adhesive base 88 andtubing 86.

As noted above, the ability to combine such elements, either integratedwith one another, stored with one another, or installed with oneanother, can simplify use. In these and other exemplary embodiments ofthe present invention, such devices can further benefit from theprovision of other exemplary strain relief elements. For example,flexible joints or materials in the tube set connections can be used inplace of elements that secure the tube at a position away from the set,or which secure extra portions of tubing to absorb movement. Forexample, FIG. 5 is a perspective view of an exemplary concertina-typestrain relief in accordance with an embodiment of the present invention.

In FIG. 5, a flexible joint 90 is provided at some point along a tubeset connection, at the infusion set, infusion pump or somewheretherebetween. The flexible joint 90 can be configured as a concertina(i.e., bellows), constructed of silicone or similar materials, to allowmovement between one end and another end. In an exemplary embodiment,the flexible joint 90 can be incorporated into the infusion set itselfand can include an adhesive patch 92 to be secured at an infusion site.

FIG. 6 is a cross-sectional view of another exemplary flexible jointthat is provided at some point along a tube set connection, at theinfusion set, infusion pump or somewhere therebetween. The flexiblejoint of FIG. 6 can be configured as a male end configured to beslidably captured within a female end to allow movement between one endand another end while maintaining a seal between each. The flexiblejoint is configured as a two-part, connectable catheter to allowmovement between a male end 94 and an opposite female end 96. The femaleend 96 comprises an opening surrounded by detents 98. The detents 98 aredeflectable by engagement with the male end 94. Specifically, the maleend 94 can comprise inclines 95 and a recess 97 to slidably capture thedetents 98 of the female end 96, and permit a degree of movement whileproviding a seal between each. The detents 98 can be strongly biasedtoward the recess 97 when assembled to provide a fluid-tight sealbetween ends 94 and 96.

As noted above, the infusion pump is another part of the assembly ofinfusion set elements which work together to deliver insulin or othermedicament to an infusion site. In exemplary embodiments of the presentinvention, such devices can benefit from the provision of a medicamentpump that is configured to pump in both directions, such as aperistaltic pump or a diaphragm pump. The infusion set and pump can thenbe configured to use the pump to evacuate the reservoir, ideally aflexible reservoir, pressurize the insulin vial or other medicamentsupply, and draw fluid in from the insulin vial to the reservoir. FIGS.7A to 7E, and FIGS. 8A to 8D, are views of an infusion systemincorporating a linear peristaltic pump as another part of an assemblyof infusion set elements which work together to deliver insulin or othermedicament to an infusion site.

FIGS. 7A to 7E are block diagrams of an infusion system incorporating alinear peristaltic pump that can be combined with an infusion set andused to deliver insulin or other medicament to an infusion site, andFIGS. 8A to 8D are perspective views of an exemplary use of such aninfusion system. A peristaltic pump is a positive displacement pump forpumping fluids using a flexible tube which is periodically compressedand released thereby forcing fluid to be pumped through the tube. Asshown in FIG. 7A, an infusion set can comprise a reservoir 102, vial 104and introducer needle, soft catheter, or in-dwelling cannula 106. Thereservoir 102, vial 104 and introducer needle, soft catheter, orin-dwelling cannula 106 can be connected via a valve 108. A linearperistaltic pump 100 can be provided at any convenient position such as,for example, between the reservoir 102 and the valve 108.

In FIG. 7B, the linear peristaltic pump 100 can be operated to draw airup into the introducer needle, soft catheter, or in-dwelling cannula 106and into the reservoir 102. When a vial 104 is coupled to the valve 108in FIG. 7C, the valve 108 and linear peristaltic pump 100 can then beoperated to force the air from the reservoir 102 into the vial 104 topressurize the vial 108. The valve 108 and linear peristaltic pump 100can then be operated to pump medicament from the pressurized vial 104 tofill the reservoir 102 in FIG. 7D. The valve 108 and linear peristalticpump 100 can then be operated to pump medicament from the reservoir 102to the introducer needle, soft catheter, or in-dwelling cannula 106 inFIG. 7E. FIGS. 8A to 8D are perspective views of an exemplary use ofsuch a linear peristaltic pump.

FIG. 8A illustrates an assembly 110 containing therein one or more ofthe linear peristaltic pump 100, reservoir 102, introducer needle, softcatheter, or in-dwelling cannula 106 and valve 108. In FIG. 8A thelinear peristaltic pump 100 is used to draw air into the reservoir 102.Once the vial 104 is connected as shown in FIG. 8B the linearperistaltic pump 100 is used to pressurize the vial 104 then fill thereservoir 102 from the now pressurized vial 104. Once the vial 104 isremoved as shown in FIG. 8C, the linear peristaltic pump 100 is used topump the content of the reservoir 102 to the introducer needle, softcatheter, or in-dwelling cannula 106 as shown in FIG. 8D.

A Piezo device can also be utilized as part of an infusion pump,infusion set, or as a separate component for use with either an infusionpump or infusion set. For example, a Piezo-electric pump can be used tomove medicament, and can also be used to vibrate an introducer needle,catheter, or in-dwelling cannula on insertion to prevent tenting of theskin. The vibrations caused by the Piezo device or Piezo-electric pumphelp the edges of the introducer needle, catheter, or in-dwellingcannula to cut tissue, causing a smoother entry of the introducerneedle, catheter, or in-dwelling cannula into the tissue. For example,FIGS. 9A to 9C are enlarged perspective views of an infusion systemincorporating a Piezo device that can be used to deliver insulin orother medicament to an infusion site in accordance with such anembodiment of the present invention.

FIG. 9A illustrates an infusion set 210 coupled to a Piezo device 200that can be incorporated with, or serve as an infusion pump, or whichcan be incorporated with, or serve as an infusion set, or as a separatecomponent for use with either an infusion pump or infusion set. A Piezodevice is one that incorporates materials that change shape when avoltage is applied, such that the changing shapes can be used to performa number of tasks. In this case, the Piezo device 200 can be constructedto operate as a very small pump, or to create slight vibrations whencontrolled to do so. In the exemplary embodiment, the Piezo device 200can be constructed to provide a communicable vibration to the infusionset 210 and specifically, to the introducer needle, catheter, orin-dwelling cannula 202 of the infusion set 210. If a Piezo device 200is utilized as part of an infusion patch pump or other infusion set, thePiezo motion can be used to enhance the puncture characteristics of theintroducer needle, catheter, or in-dwelling cannula 202 into the surface204 of the skin as shown in FIG. 9C thereby, for example, reducingtenting of the skin surface as shown FIG. 9B of a conventional insertionwithout vibration, which can be beneficial to the shallow placement ofan introducer needle, catheter, or in-dwelling cannula. The infusionpump can incorporate such features to aid needle, catheter, orin-dwelling cannula insertion or improve pump characteristics. Stillother features that can be incorporated into such an infusion system orpump include a heat exchanger (not shown) to maintain the temperature ofthe insulin or other contents, or cool the insulin or other componentsof the pump if the temperature rises above a set point.

In other exemplary embodiments, actual pump functions can be performedby modifying elements of the infusion system. For example, FIGS. 10A and10B are views of a collapsible cylinder or reservoir that can be used todeliver insulin or other medicament to an infusion site in accordancewith an embodiment of the present invention.

FIGS. 10A and 10B are cross-sectional views of a collapsible cylinder orreservoir 220 that can be used to deliver insulin or other medicament toan infusion site. In the embodiment of FIGS. 10A and 10B, an insulinvial, cartridge, reservoir or similar element can be constructed from aportion of tubing, such as a portion of the infusion set tubing or othermedical grade tubing, preferably one having a high elongationcharacteristic (e.g., elongation capability of 200% to 800%). In anexample shown in FIGS. 10A and 10B, for a dimension X, the tubing can beexpanded to a length 6X to create a chamber of length 4X, and whenreleased, the tubing can contract to a length 2X, substantiallycollapsing the entire chamber therein. To do so, the tube segment can befiled with medicament to force the tube segment 222 into an elongatedshape as shown in FIG. 10A. The tube segment can be closed at either endwith contoured walls 224 and 226 to reduce dead space when contracted.The filling can further create a tensile force sufficient to deliver thecontent when released and the tube segment 224 contracts due to its highelongation characteristic as shown in FIG. 10B. The content can bedelivered through a cannula or further tube segment 228. In yet anotherexemplary embodiment, the tube segment can be disposed within areservoir chamber. For example, FIG. 11A is a cross-sectional view ofanother collapsible cylinder or reservoir disposed within a structuredchamber that can be used to deliver insulin or other medicament to aninfusion site in accordance with an embodiment of the present invention.

FIGS. 11A and 11B are enlarged cross-sectional views of a collapsiblecylinder or reservoir 240 disposed within a structured chamber that canbe used to deliver insulin or other medicament to an infusion site. Inthe embodiment of FIG. 11A, an insulin vial, cartridge, reservoir orsimilar element is constructed from a portion of tubing 242, such as aportion of the tube set tubing or other medical grade tubing, preferablyone having high expansion characteristic. The tube segment can bedisposed within a housing 250 or other tube segment. Accordingly, thetube segment 242 can be filled with medicament to force the tube segment242 into an expanded shape as shown. The tube segment 242 can be closedat either end with contoured walls 244 and 246 to reduce dead space whencontracted. At least one of the contoured walls, such as contoured wall244 in FIG. 11A can be provided with spaces or gaps where slidablycontacting the housing 250 to provide clearance for folding sections ofthe tube segments 242 during collapse as shown in FIG. 11B. The fillingcan create a tensile force sufficient to deliver the content whenreleased and the tube segment 242 contracts due to the high expansioncharacteristic and can fold into gaps provided in the contoured wall244. The content can be delivered through a cannula or further tubesegment 248.

The housing 250 can be sized to prevent contact with the expanding tubesegment 242, or the outer diameter of the tube segment 242 can belubricated to allow the surface of the tube segment 242 to slide freelyacross the inner surface of the housing 250. In yet another exemplaryembodiment, one or more of the moving wall segments in the reservoir cancomprise a lubrication membrane to provide lubrication for movingelements. For example, FIGS. 12A to 12D are cross-sectional views ofsuch an embodiment that can be used to deliver insulin or othermedicament to an infusion site in accordance with an embodiment of thepresent invention.

FIG. 12A is a cross-sectional view of a reservoir housing 300 thatcomprises one or more moving wall segments such as the plunger orstopper 302 that includes a lubrication membrane 304 (i.e., an oilimpregnated membrane) between stiff elastomer walls 306 and 308. In theexemplary embodiment shown, the moving wall segment 302 is a plunger orstopper of a syringe or reservoir, and provides lubrication featurestherein such that the remainder of the syringe or reservoir does notrequire a separate lubricating coating on interior walls. Byimpregnating O-rings, washers, disks or other porous membranes 304 inthe plunger or stopper 302 with a lubricant, and designing the plungeror stopper 302 to release the lubricant of the porous membranes 304 onlywhen dispense/inject forces are present, the moving wall of the syringeor reservoir is lubricated, but insulin or other medicament contents arenot exposed to the lubricant of the porous membrane 304 preferably atall, and in other cases are not exposed to the lubricant of the porousmembrane 304 until infusion begins, and exposure at that time is minimalthroughout the infusion process.

To do so, the lubrication membrane 304 and elastomer walls 306 and 308are configured to be driven along a central axis by a syringe engagement310 when filling from a vial 312 as shown in FIG. 12A. The syringeengagement 310 drives the plunger or stopper 302 without compressing thelubrication membrane 304, so that the syringe can be utilized forfilling or emptying the syringe from the vial 312. The syringeengagement 310 can be removed as shown in FIG. 12B, and replaced with apump engagement 314 as shown in FIG. 12C. The pump engagement 314 is notconfigured to drive the plunger or stopper 302 along a central axis aswith the syringe engagement 310, but provides wider contact elements 316extending beyond the central axis. In doing so, the wider contactelements 316 of the pump engagement 314 bear on the outer diameter ofthe elastomer wall 308 of the plunger or stopper 302, deflecting thewall 308 into the membrane 304, compressing the lubrication membrane 304and releasing lubrication between the outer diameter of the plunger andthe inner diameter of the reservoir as shown in FIG. 12D. Accordingly,the lubricant of the lubrication membrane 304 is only dispensed whendispense/injection forces are present, such that the insulin or othermedicament contents will not be exposed to the lubricant of the porousmembrane 304 preferably at all, and in other cases will not be exposedto the lubricant of the porous membrane 304 until infusion begins andexposure at that time will be minimal throughout the infusion process.These embodiments described above incorporate pump features that benefitmedicament or pumping operations. However, in yet other exemplaryembodiments, the pump can incorporate features unrelated to pumping, butwhich still form part of an assembly of infusion set elements which worktogether to deliver insulin or other medicament to an infusion site. Asan example, FIG. 13 shows a tubing recoiler utilized as part of aninfusion pump.

FIG. 13 is a perspective view of a tubing recoiler utilized as part ofan infusion pump. An infusion pump 350 is shown coupled with an infusionset 352 via a length of tube 354. However, excess tube between theinfusion pump 350 and the infusion set 352 can be subject tointerference and transfer undesired movement to the infusion set 352through contact. Accordingly, it is desirable to minimize the length oftubing 354, but provide sufficient length to ease use and placement ofthe infusion set 352. In other systems, a separate tubing recoiler 360has been provided to serve this function. However, the provision of sucha separate element requires the user to carry, install and manage theseparate component. Accordingly, exemplary embodiments of the presentinvention incorporate the separate tubing recoiler into the infusionpump 350.

Specifically, the pump 350 integrates the tubing and recoiler toautomatically recoil excess tubing via a spring mechanism or otherwise,and dispense tubing in a reverse manner, so that another separate deviceis not required to manage excess tubing. The tubing 354 connecting theinsulin supply and pump 350 to the infusion set 352 can be packaged on aspring-loaded circular reel disposed within the pump 350. The tubing 354can enter and exit the pump 350 and wrap about a spring mechanism. Sincethe construction of a spring-loaded circular reel is known to thoseskilled in the art, additional features of such a reel are omitted forclarity. The circular reel can further comprise a catch/latch mechanismas known to those skilled in the art such that pulling the tube 354 afirst time feeds a length of tube, and a catch is provided to prevent areverse spring-urged action. Upon pulling the tube 354 a second time,the catch is released so that the reverse spring-urged action urges thetube 354 back into the pump 350. In doing so, the reel device allowsslack tubing to be fed out precisely, with spring resistance maintainingthe excess tubing rolled up and stored. The locking catch or latch canbe provided to allow the user to prevent inadvertent retraction orextension once a satisfactory length of tubing has been deployed.

In exemplary embodiments of the present invention, the housings, hubsand other elements of the infusion system can be constructed of moldedplastic materials, polycarbonate, thermoplastic polymers such aspolyethylene terephthalate (PET and PETG), or similar materials. Springsand introducer needles can be constructed of stainless steel or similarmaterials. Although the embodiments described above are dimensioned andconfigured for subcutaneous injections, they can also be used for othertypes of injections, such as intradermal or intramuscular injections.

Further, features such as 360 degree rotation or partial rotation, lineset connection, septum location, and so on, can be located in the strainrelief rather than in the infusion set base or hub to which the Tefloncannula or catheter is secured. The strain relief can then be used tominimize the effect of line set movement or tugging, and motion thatoccurs at the catheter or cannula. This includes (1) tugging on the lineset, as occurs when the line set catches on a door knob or other objectand exerts a force to pull the infusion set from the skin, and (2)forces applied directly to the infusion hub, e.g. the patient orinfusion set bumps into an object and a force is applied to the exteriorof the infusion set, or the patient rolls over during sleep.

Further, one or more of the exemplary embodiments of the presentinvention can be provided with a skin contacting adhesive layer andbacking. Precise insertion is achieved by first removing an adhesivecover of the adhesive layer, and then adhesively securing the infusionset hub to the infusion site via the adhesive, which permits the user toactivate the inserter or place the catheter as described above at theproper alignment. Following adhesive attachment, the introducer needle,in-dwelling cannula and/or catheter is driven into the skin surface at acontrolled high rate of speed to minimize the risk of misalignment atinsertion. Further, the adhesive at or very near the insertion sitesecures the skin surface and minimizes tenting of the skin surfaceduring insertion.

In current infusion sets which deliver insulin or other medicament tothe subcutaneous layer, the catheter is usually not isolated from anyundesired outside forces, which may cause pain when translated to thecatheter which then moves within the skin. Also, other devices faceproblems of premature or unintended catheter removal when the device isbumped, if the catheter is not isolated from the outside forces. In theexemplary embodiments of the present invention, the catheter can beisolated from outside forces by at least one flexible or resilientfeature or strain relief.

Although only a few exemplary embodiments of the present invention havebeen described in detail above, those skilled in the art will readilyappreciate that many modifications are possible in the exemplaryembodiments without materially departing from the novel teachings andadvantages of this invention. Accordingly, all such modifications areintended to be included within the scope of the appended claims andtheir equivalents.

The invention claimed is:
 1. An apparatus comprising: a tube having atleast one tube segment, a distal end secured to an infusion set and aproximal end secured to an infusion pump: a securing member forreleasably securing said tube segment, said tube segment being a portionof said at least one tube between said distal end of said tube and saidproximal end of said tube; the securing member comprising a circularsection of flexible material having an open portion, the securing memberhaving a longitudinal axis, and wherein the securing member is adaptedto deflect in a direction around the longitudinal axis to receive thetube segment and contract to secure the tube segment once received; anda securing member base comprising an adhesive layer for adhesivelysecuring said securing member base to a skin surface and a planar topsurface opposite the adhesive layer, wherein said securing member iscoupled with said securing member base; wherein said securing member iscoupled to said securing member base with a pin received within thesecuring member base and captured within an opening of the securingmember base, the opening having a narrow portion on a top surface of thesecuring member base, and a wide portion on a bottom surface of thesecuring member base, and where the pin conforms in shape to the openingto permit 360 degree free rotation of the securing member about thesecuring member base, and wherein the pin extends in a directionperpendicular to the planar top surface such that when secured to theskin with the adhesive layer, the securing member is rotatable about anaxis normal to said planar top surface and to the skin surface.
 2. Anapparatus as claimed in claim 1, wherein said securing member comprisesan adhesive cover to adhesively secure said tube segment to saidsecuring member.